An OB-GYN, a leading anti-abortion activist and a few Republican lawmakers worked together on a proposal — introduced Wednesday in two different late-session bills — that they say will give doctors some explicit clarity on when they can legally provide abortions to protect their pregnant patient’s life.
Dr. Jeff Goldberg told two legislative committees Wednesday there’s “a tremendous amount of ambiguity” in state law right now, making it hard for some patients to quickly get life-saving care. He sees the legislation as an opportunity to make initial improvements that can pass Kentucky’s Republican-run legislature.
“We have come together to work on parts that we think, from a political standpoint, can be managed in the short term,” he said. “We're simply trying to ensure that, on a day-to-day basis, doctors feel comfortable providing evidence-based care for women with complications of pregnancy that, again, have nothing to do with elective abortion.”
Kentucky’s current ban makes abortion illegal unless there’s a life-threatening health risk. That would remain the case if the legislature approves either House Bill 144 or House Bill 90, which have both been amended with identical language.
The original version of House Bill 414 required providers to refer parents facing non-viable pregnancies to programs encouraging families to create memories with a fetus that has no chance of survival. The substitute bill called in the House Health Services committee Wednesday afternoon included the language that essentially adds explicit allowances for doctors to provide an abortion under certain circumstances.
Wednesday evening in a Senate committee meeting, the same amended language on abortion from HB 414 was added to House Bill 90 just before it passed, which was originally just a bill to allow freestanding birthing centers.
Under both bills, the permissible conditions for doctors to provide an abortion include ectopic or molar pregnancies and cases of sepsis or hemorrhage when an impending or completed miscarriage causes a “life-threatening infection or excessive bleeding.”
The bills also say “lifesaving miscarriage management” is allowed during completed or “unavoidable” incomplete miscarriages, and they say doctors can remove an embryo or fetus after a miscarriage as long as fetal cardiac activity isn’t detected.
In the committee debate on HB 414, Democratic Rep. Lisa Willner of Louisville said the language appears written in a way that can be read as requiring doctors to wait, in certain circumstances, until women are more endangered, not less, before they can act.
“I think the effort was to add clarity, but I think what it does is to codify that a woman has to suffer a lot … before the doctor is free and clear to treat that,” she said.
Goldberg indicated the goal of the bill is to prevent women from having their care delayed while they bleed out. He and the legislation’s other architects also noted they see it as the start, not the end, of tackling this issue.
With limited time left in Kentucky’s annual lawmaking session, Goldberg said, “We have a few days to get some good done, as opposed to getting everything perfect.”
Goldberg is the legislative advocacy chair for Kentucky’s chapter of the American College of Obstetricians and Gynecologists, a leading professional association that opposes bans on abortion. It was unclear, during Wednesday’s meeting, if the bill has the support of the local chapter as a whole.
Republican Reps. Kimberly Moser, Jason Nemes and Nancy Tate worked with Goldberg and Addia Wuchner, executive director of the anti-abortion group Kentucky Right to Life, on the updated version of HB 414.
“There's been a lot of misinformation, a lot of concerns and fear, out there about what can be done in the medical practice. So jointly we worked together to put those fears at rest and make it clear,” Wuchner said.
Nemes said Goldberg called him months ago about pursuing legislation like this, but he didn’t think getting to this point would be possible. “But we have people who don't always trust one another, who've looked each other in the eyes, who’ve come up with this really good bill, I think…”
“A lot of people from all sides of this debate probably want to go further. I respect all those positions,” he said. “This is solving a discrete problem, and it will save the lives of mothers.”
Another key aspect of HB 414 and HB 90 is that they basically wouldn’t count it as an abortion if a doctor ends a patient’s pregnancy under conditions deemed permissible by the state.
The legislation’s architects indicated the goal there is to allay doctors’ fears that treating a life-threatening problem could be considered an illegal abortion.
In broadly accepted medical terminology, though, abortion refers to ending a pregnancy, regardless of the reason why.
Tamarra Wieder of Planned Parenthood Alliance Advocates said the redefinition of abortion mirrors language used by “anti-abortion extremist groups.”
She also said the way the bills add the terms “lifesaving” and “life-threatening” to the provisions regarding miscarriage management, sepsis and hemorrhages actually could make doctors wait longer to provide an abortion in those circumstances. “This enshrines the delay,” she said.
“It is a very technical bill. And these technicalities and word choices matter, especially in care that is highly scrutinized and highly politicized,” she told the Kentucky Center for Investigative Reporting.
The updated version of HB 414 still does what the bill originally set out to do: Require health care providers to make perinatal palliative care services, like spiritual support and making keepsakes, available to pregnant patients if their embryo or fetus is diagnosed with a fatal condition.
The perinatal palliative care proposal failed to pass the legislature last year. Democratic lawmakers and reproductive rights advocates said the bill could make doctors even more wary of discussing other options, like going out of state for an abortion, with patients whose pregnancies are nonviable.
While HB 414 passed out of the House committee with Republican support, it still has not received any readings in that chamber, meaning there is not enough time to pass the bill before the governor’s veto period begins Saturday.
However, HB 90 could pass both chambers and head to the governor’s desk by Friday, as it already passed the House and could be passed by the full Senate as early as Thursday. If both chambers concur on the same version of the bill by that time and Democratic Gov. Andy Beshear vetoes it, the GOP supermajority could override the veto on the final two days of the session in late March.
Goldberg, Nemes, Wuchner and Tate all testified for the provisions in HB 90 late Wednesday night in the Senate committee, where it again passed with only Republican support.
Nemes told Kentucky Public Radio the language wasn’t also included in HB 90 just because it had a better chance of passing before the veto period than HB 414, but did add that “it is important to pass it before the veto period.”
This story has been updated to include the advancement of HB 90 with similar language.
State government and politics reporting is supported in part by the Corporation for Public Broadcasting
